Athetosis
| Classification according to ICD-10 | |
|---|---|
| R25.8 | Other and unspecified abnormal involuntary movements |
| G80.3 | Dyskinetic cerebral palsy |
| ICD-10 online (WHO version 2019) | |
The athetosis is the medical term for involuntary slowly played out the end, driving out movements of hands or feet, which are usually accompanied by joint hyperextension. It is counted among the extrapyramidal hyperkinesias . A frequent cause is perinatal damage to the basal ganglia, which means that movements are not flowing, but rather “suddenly”. The transitions from athetosis to dystonia and to choreic disorders are fluid, see also choreoathetosis .
Symptoms
Athetosis as one of the most common forms of extrapyramidal paralysis is based on damage to the striatum (striped mound, term for part of the basal ganglia of the brain ), which means that the inhibitory effect on voluntary motor skills is eliminated.
The main feature of athetoses is their impaired tonic coordination, which leads to hyperkinetic movement sequences (excessive movement activity, uncontrolled, slow, screwing movements of the limbs and trunk, involuntary body movements, muscle twitching). With attention and mental excitement, the movement restlessness increases, it generally stops during sleep. An observable phenomenon of athetosis is slow, indiscriminate, worm-like or helical movements, especially on the face, neck muscles, and distal limbs. Characteristic are further bizarre overstretching, the spreading of the fingers, the grimacing with an open and distorted mouth, salivation and cramped neck posture as well as the turning movement of the head. The gait is excessive and stumbling; in contrast to spasticity , the constantly changing excess movements do not cause any contractures . Athetosis and spasticity are often combined.
Here the interaction of agonists and antagonists is disturbed: on the one hand, a constantly changing muscle tone that hinders the posture and, on the other hand, constantly unchecked excessive movements in bizarre forms that hinder targeted movements. The sudden loss of postural control cannot be compensated for by hypotonic muscle activity. Overmobility in certain joints can lead to dislocations . The motor strategy development is not clearly recognizable and can be misinterpreted. Likewise, involuntary facial expressions and gestures , speech disorders lead to communicative misunderstandings that can lead to emotional disorders. The sensorimotor development of the affected children is usually severely delayed (late walking, sometimes only with aids).
Treatment goals
The treatment aims to change postural control through voluntary control of involuntary movements. It should improve breathing and support communication, make it easier to eat and move independently (also with aids). It also aims to avoid secondary damage on the sensorimotor and emotional-social level.
etymology
Athetosis is derived from the ancient Greek PPP θετός thetós of the verb τιθέναι tithénai "induce", which is preceded by an alpha privativum that reverses the meaning . Literally athetosis means something not caused , i.e. H. Involuntary .
Individual evidence
- ^ Wilhelm Gemoll: Greek-German school and hand dictionary. Munich / Vienna 1965.
